Active NPI
Bryan Mershon, PH.D.
- Clinical Psychologist
- Los Angeles, CA
National Provider Identifier
1346322237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY 10970
- Practice address
- 550 S Vermont Ave FL 3
County of Los Angeles Department of Mental Health
Los Angeles, CA 90020-1912 - Phone
- (213) 738-6120
- Fax
- (213) 736-5804
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY 10970 | CA | Primary |
Addresses
Primary practice location
550 S Vermont Ave FL 3
County of Los Angeles Department of Mental Health
Los Angeles, CA 90020-1912
Mailing address
PO Box 29
Culver City, CA 90232-0029
Phone (213) 738-6120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY 10970 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1346322237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 29",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902320029",
"telephone_number": "213-738-6120",
"fax_number": "213-736-5804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "550 S VERMONT AVE FL 3",
"address_2": "COUNTY OF LOS ANGELES DEPARTMENT OF MENTAL HEALTH",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900201912",
"telephone_number": "213-738-6120",
"fax_number": "213-736-5804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERSHON",
"first_name": "BRYAN",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY 10970",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.